Being a glaucoma suspect means that you carry some features or characteristics that indicate a chance you could develop the condition in the future.It doesn’t mean that you definitely have glaucoma, but you will have been referred because some features of your eye have been identified as putting you at risk.
To understand why this might be, we’ve compiled a list of common anomalies that may warrant a referral to an ophthalmologist.
Is my optic nerve normal or abnormal?
The optic nerve can vary a lot in appearance from one person to the next. This means it’s sometimes difficult to know whether someone’s optic nerve is normal or abnormal.
If the appearance of your optic nerve does not change over time, however, it’s likely that it’s normal. However, if there is a change, it may suggest a progressive (worsening) disease like glaucoma.
What are the chances of a glaucoma suspect developing the condition?
It’s important to understand that being identified as a glaucoma suspect does not automatically mean that you have, or will develop, glaucoma. The risk will depend on many factors and more tests will need to be carried out. Remember, significant damage can be prevented if the disease is identified in the early stages.
There are lots of complex variations in glaucoma and how it is detected and diagnosed. However, all eyes are unique in terms of shape and size. This can lead to suggestions of glaucoma purely from an appearance perspective, when, in fact, the eye is actually healthy. Some of the variations are below:
Optic nerve
Myopic (short-sighted) people usually have longer eyeballs than others. As a result, their optic nerves can look like they are damaged, when they are actually healthy.
Likewise, some people have tilted optic discs, meaning the optic nerve can enter the back of the eyeball at an angle. This can give the impression that the nerve is damaged when it isn’t.
Additionally, some people have asymmetric optic discs, where the nerve can appear to be larger or shaped differently in one eye. For most people, the nerves look similar, so this can be another reason for referral.
Visual field
The visual field test measures how much central and peripheral vision each eye has. This can be a tricky test to perform but the result of the test can improve if repeated.
What’s more, there are other factors and conditions that can cause a defect in your visual field other than glaucoma, such as damage to the retina at the back of the eye or previous head trauma.
Eye pressure
Not every glaucoma patient has high intraocular pressure (IOP) in their eye. In fact, up to half of all diagnosed cases actually have eye pressure that is quite normal. But it’s worth noting that, some eye conditions and medications can cause higher pressure and even the thickness of the cornea, the clear layer at the front of your eye, can affect the result of pressure measurements.
I’ve been identified as a glaucoma suspect, what happens next?
There are many different stages towards a diagnosis of glaucoma. What happens next will depend on whether you are an early glaucoma suspect or further along in the progression of developing the disease. Remember, being identified as a glaucoma suspect is not a diagnosis of glaucoma, you simply fit the profile of a typical glaucoma case.
If you are identified as a glaucoma suspect, an ophthalmologist may choose to monitor your eye health over a series of visits before beginning glaucoma treatment or discharging you. The appearance of your optic nerves will be monitored regularly, too.
If changes are detected, further observation or treatment will be considered. If glaucoma is diagnosed, it can be treated with daily eye drops, laser treatment, surgery or a combination of treatments. You can learn more about glaucoma treatment in our dedicated resource.
Whatever the reason for your referral, you can be assured that it has been made with valid clinical concerns. There are also many other eye conditions that can be detected through regular testing, so even if your referral leads to discharge with no treatment, it is vital to attend regular eye tests.
At Specsavers, we pride ourselves on having the latest diagnostic technology, including digital imaging and photography of the optic nerves. For more information on glaucoma, including diagnosis and treatment, head over to our dedicated glaucoma educational resource.
References
- Vass C, Hirn C, Sycha T, Findl O, Sacu S, Bauer P, Schmetterer L. Medical interventions for primary open angle glaucoma and ocular hypertension. Cochrane Database of Systematic Reviews. 2007.
- NICE National Institute for Health and Care Excellence. (2017). Glaucoma: Diagnosis and Management. [Online]. Available at: https://www.nice.org.uk/guidance/ng81 [Accessed 21 June 2019].
- Bowling, B. Kanski's Clinical Ophthalmology: A Systematic Approach. Optometry and Vision Science. 2015.4. RNIB. (no date). Key information and statistics on sight loss in the UK. [Online]. Available at: https://www.rnib.org.uk/professionals/knowledge-and-research-hub/key-information-and-statistics [Accessed 21 June 2019].
- Kamal, D and Hitchings, R. Normal tension glaucoma—a practical approach. British Journal of Opthamology. 1998; 82: 835-840.
- Klein BE, Klein R, Sponsel WE, et al. Prevalence of glaucoma. The Beaver Dam Eye Study. Ophthalmology. 1992; 99: 1499–1504.